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Psychosomatic aspects of skin diseases from the standpoint of immunology.

The psychosomatic aspects of skin disease were studied both clinically and experimentally, from the standpoint of immunology. We found that emotional stress has a great influence on the immune system, as was manifested in skin disease. Skin test in allergic patients significantly improved with autogenic training and relaxation. For clarification of the effects of autogenic training and relaxation, various parameters were simultaneously assessed during the treatment. The serum levels of histamine and dopamine-beta-hydroxylase fluctuated, as determined by the microvibration test. The levels of IgE and findings on the PK test varied only slightly. Before the onset of urticaria, there were changes in the life-style and considerable stress in daily life as well as exposure to an allergen. Using mice subjected to stress, the functions of T cells and macrophages were evaluated. Stress appeared to have a definite influence on the functions of these cells, as related to the important role of the immune system and skin. Thus, the role of stress in clinical disease must always be given consideration.

Adult↗

Epidemiology of psychosomatic disorders in schizophrenic patients: methodological issues.

The value of an epidemiological study investigating the prevalence of certain somatoform diseases in schizophrenic patients can be strengthened by attention to the following methodological principles: (1) sufficient size of sample; (2) representativeness of sample, controlling if possible such variables as age range, inpatient or outpatient status, ward population or milieu and cultural aspects; (3) study of control groups in same milieu with other psychiatric diagnoses; (4) clear specification of diagnostic criteria employed; (5) establishment of interrater reliability concerning psychiatric diagnosis, patient historical data or medical record information.

Arthritis, Rheumatoid↗

Lichen simplex chronicus during lithium treatment.

A patient who was taking lithium developed an intensely pruritic lesion that remitted after lithium discontinuation and recurred with readministration. The condition was successfully treated with local steroid application, which permitted continuation of lithium maintenance.

Administration, Topical↗

Diflorasone diacetate: vasoconstrictor activity and clinical efficacy of a new topical corticosteroid.

Diflorasone diacetate, a new topical corticosteroid, was generally more potent than three high potency reference standards (fluocinonide, beta-methasone 17-valerate and fluocinolone acetonide) when the compounds were dissolved in 95% alcohol and applied in vasoconstrictor assays in healthy volunteers. On the basis of additional vasoconstrictor assay results, a 0-05% concentration of the steroid in a cream vehicle containing 15% propylene glycol was developed for therapeutic evaluation. In a double-blind comparison in 384 patients with dermatoses, 0-05% diflorasone diacetate cream was as effective as 0-05% fluocinonide cream in the therapy of lesions of psoriasis or atopic/neurodermatitis.

Administration, Topical↗

A study of the local tolerance of tibicorten during long-term application.

Regular observation of 16 patients with chronic skin diseases, treated twice daily with applications of Tibicorten for 2 to 14 weeks, showed that this treatment did not give rise to development of local side-effects. Even protracted local application of Tibicorten is tolerated excellently.

Administration, Topical↗

A study to ascertain whether hydrocortisone 17-butyrate (Locoid) 0.1% cream has any effect on the hypothalamic-pituitary-adrenal axis in children with skin diseases.

A study was conducted in eight children requiring topical corticosteroid treatment for dermatological disorders. The trial was carried out with hydrocortisone 17-butyrate (Locoid) 0.1% cream. The children were treated twice daily with Locoid cream applied to areas involving at least 20% of the body surface for a period of 2 to 3 weeks. Statistical analysis did not reveal any significant changes in plasma cortisol levels after treatment compared to pre-treatment baseline levels. No side-effects were reported.

Burns↗

Transmittance properties of flurandrenolide tape for psoriasis: helpful adjunct to phototherapy.

BACKGROUND: Flurandrenolide tape is a valuable agent in the treatment of lichen simplex chronicus and in psoriasis. The corticosteroid is helpful for reducing the symptoms and induration of the lichen simplex chronicus lesion, and occlusion of the lesion with the tape reduces the patient's opportunity to rub and scratch the affected area. OBJECTIVES: The purpose of this study was to determine to what extent flurandrenolide tape may block ultraviolet (UV) light and interfere with phototherapy of psoriasis. METHODS: Flurandrenolide tape was applied to quartz spectroscopy cuvettes, and the absorption spectrum was determined using a Beckman DU-600 spectrophotometer. The effect of the tape on UV light transmission was also determined using our UVA-UVB office phototherapy unit. RESULTS: Flurandrenolide tape has considerable UV absorption in the UVC range with less absorption in the UVB and UVA range. The transmittance is greater (less absorption) with longer wavelengths. There was greater UV absorption in the UVB range than in the UVA range. CONCLUSION: Although flurandrenolide tape may be left in place during PUVA therapy, adjustment of UV dose or removal of the tape is probably needed during UVB phototherapy.

Administration, Topical↗

Pruritus circumscriptus sine materia: a sequel of postzosteric neuralgia. Evaluation by quantitative psychophysical examination and laser-evoked potentials.

A case of circumscribed pruritus existing since 1 year on clinically uninvolved skin is reported, in which careful history revealed a 5-year previous episode of herpes zoster in the same dermatome. Impairment of cutaneous sensitivity was evaluated by use of a quantitative psychophysical examination and laser-evoked cortical potentials (LEP).

Aged↗

Unusual case presentation of lichen simplex chronicus, Hodgkin's lymphoma, and nonpuerperal hyperprolactinemia-galactorrhea.

OBJECTIVE: To report the association of nonpuerperal galactorrhea and severe pruritus with clinical stage IIB Hodgkin's lymphoma. METHODS: We present a detailed history, findings on physical examination, laboratory data, and results of diagnostic imaging in a 25-year-old woman. A review of the related literature and speculations about possible etiologic factors for this association are provided. RESULTS: Dermatologic evaluation of the patient revealed lichen simplex chronicus with multiple excoriations on the anterior chest area and lower extremities. High serum prolactin concentrations and easily expressible galactorrhea were present. Magnetic resonance imaging of the sella with 1-mm cuts, however, revealed a normal pituitary gland. Computed tomography showed multiple enlarged mediastinal lymph nodes, and a left supraclavicular lymph node biopsy revealed the presence of Reed-Sternberg cells and lymphocyte alterations consistent with the diagnosis of Hodgkin's lymphoma. After one cycle of chemotherapy for management of the lymphoma, parallel reductions in serum prolactin concentrations and galactorrhea were noted. CONCLUSION: Possible causes for this syndrome include afferent mammary nerve stimulation resulting from scratching of pruritic skin and cytokine-induced hypersecretion of prolactin attributable to the lymphoma. Although uncommon, this syndrome may serve as an important harbinger of developing Hodgkin's lymphoma, and its disappearance may signify a therapeutic response.

Adult↗

Eosinophilic neuritis and eosinophilic panniculitis in a patient with advanced acquired immunodeficiency syndrome.

The pruritic, papular eruption of human immunodeficiency virus with associated peripheral eosinophilia is well documented. We describe a 32-year-old African American man with advanced acquired immunodeficiency syndrome; a generalized painful, pruritic, papular rash; peripheral blood eosinophilia; and perineural eosinophilic infiltrates with eosinophilic panniculitis. To our knowledge, the latter 2 features have not been previously described in the literature on human immunodeficiency virus dermatoses. We propose that eosinophilic neuritis and eosinophilic panniculitis may represent additional findings in the spectrum of cutaneous disease seen in patients with advanced acquired immunodeficiency syndrome.

Acquired Immunodeficiency Syndrome↗